NICE announces decision on type-2 diabetes treatment

The DPP-4 inhibitors should be considered in patients taking metformin who are unsuitable for treatment with a sulfonylurea, NICE has recommended.

The guidelines also suggest that exenatide should be restricted to use for severely obese patients. The GLP-1 mimetic should only be used for patients with BMIs over 35 who have problems associated with this weight and need to improve their diabetes control, NICE says.

The guidelines also recommend use of pioglitazone or rosiglitazone as second- or third-line treatments and consider the place of long-acting insulin analogues in diabetes treatment.

Dr Amanda Adler, consultant physician at Addenbrooke's Hospital, Cambridge, and guideline development group chairman, said: ‘These guidelines acknowledge that the treatment of type-2 diabetes may require many drugs, often used simultaneously.

‘These guidelines weigh up the effectiveness of these newer agents against older, standard therapies, but also consider side-effects, patient well-being, and whether these newer drugs reflect the best use of NHS resources.'